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Are complications of stress urinary incontinence surgery procedures associated with the position of the sling?
Author(s) -
Kociszewski Jacek,
Fabian George,
Grothey Susanne,
Kuszka Andrzej,
Zwierzchowska Aneta,
Majkusiak Wojciech,
Barcz Ewa
Publication year - 2017
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.13262
Subject(s) - sling (weapon) , medicine , urinary incontinence , urethra , urology , overactive bladder , urinary system , neck of urinary bladder , stress incontinence , surgery , urinary bladder , anatomy , alternative medicine , pathology
Objectives To evaluate whether the sling position is associated with particular types of complications in patients undergoing suburethral sling placement for stress urinary incontinence. Methods Data from 100 women diagnosed at the Evangelical Hospital Hagen‐Haspe with complications after suburethral sling insertion were analyzed. All patients underwent pelvic floor ultrasound to assess: urethral length, sling location in relation to the urethral length (%) and the sling distance to the longitudinal smooth muscle complex of the urethra (the sling–longitudinal smooth muscle distance). Results The shortest median sling–longitudinal smooth muscle distance was observed in patients with recurrent urinary tract infections, urinary retention and overactive bladder: 0.9, 1.1 and 1.75 mm, respectively ( P < 0.05). In women with persistent stress urinary incontinence and sling erosion, the sling–longitudinal smooth muscle distance was 3.6 and 4.6 mm, respectively ( P < 0.05). Persistent stress urinary incontinence was connected with the position of the sling in relation to the bladder neck – in these patients, the sling was closer to the bladder neck. Conclusions Sling location plays a pivotal role in the occurrence of certain complications. The sling position in the proximal part of the urethra or between the middle and proximal urethra appears to be connected with a high rate of unsuccessful stress urinary incontinence treatment. A sling–longitudinal smooth muscle distance below 2 mm is often connected with sling complications, such as overactive bladder, urinary retention and recurrent urinary tract infections.